Novel prosthetic device restores vision in eyes with post-LASIK complications

The unique design features of a fluid-ventilated scleral lens (Boston Scleral Lens Prosthesis, Boston Foundation for Sight) make it an effective option for correction of cornea first surface aberrations and management of dry eye symptoms in post-LASIK eyes, even in those that are contact lens intolerant, said Deborah S. Jacobs, MD.

The fluid-ventilated scleral lens, available through the nonprofit Boston Foundation for Sight, is a customized, fluid-ventilated, gas-permeable device that has been described as a liquid corneal bandage or ocular surface prosthesis. Its therapeutic mechanisms include masking of surface irregularity and surface astigmatism, creation of an expanded tear reservoir, shielding against the environment and lids, and support of the mucin epithelial interface.

Dr. Jacobs, medical director, Boston Foundation for Sight, and assistant clinical professor of ophthalmology, Harvard Medical School, Boston, reported findings from a retrospective review that included 75 post-LASIK eyes of 44 patients fitted with the fluid-ventilated scleral lens; 86% of eyes had a documented history of contact lens intolerance.

All eyes achieved improvement in best-corrected visual acuity, and the mean change for the group was -0.31 logMar units, which was highly statistically significant. Analyses of data from a baseline and follow-up NEI-VFQ 25, which was added to the new patient evaluations in 2006, showed a significant improvement in visual function post-fitting of the fluid-ventilated scleral lens.

"My parting words are to please remember the [lens] does not touch the cornea. Its unique design features are that it vaults the cornea independent of base curve and does not move on the eye," said Dr. Jacobs.

"Currently, there is limited awareness of this device as well as limited accessibility, since patients must travel to Massachusetts for fitting. However, we are working to address these issues and plan to have satellite facilities opening in Texas and California by the end of 2008," she added.